The Invisible Casualties of CBT

This article just below reads like a companion piece to my earlier post on my late wife’s Alison’s struggles with chronic pain.

I agree almost entirely with Alana Saltz, the author of the article, and am saddened that Alison isn’t here to read it (in fact, I had to fight my initial impulse to send it to her). Saltz lays out many of the criticisms of CBT that Alison had made to me over the years, both as a therapist herself, and as someone with chronic pain. Before hearing those criticisms, I’d always had some vague unease about CBT that I wasn’t quite able to pinpoint. It wasn’t until Alison started expressing her criticisms of CBT in the direct, concrete, and vehement way characteristic of her that I was able to re-focus my own vague, nebbish doubts about it. I wrote some of those criticisms up for grad seminars in CBT back when I was a grad student in counseling, but never did anything with what I wrote. Saltz’s piece reinforces my confidence in my criticisms; maybe I ought to take the time to write them up. Here, in any case, is a quick summary.

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The Invisible Casualties of the “Opioid Epidemic”

My wife Alison was one of the casualties of the tragedy described in the article just below. She took her life this past March by overdosing (I surmise) on the medications she’d been prescribed for chronic pain. She explicitly told me over the years that she kept a stash with her at all times in case things got bad enough for her to have to take her own life. “I have no intention of living past 70,” she’d often say. She was 57.

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Desert and Merit (4)

In a previous post, I criticized George Sher’s view that merit-based desert is based on (the recognition of) existing conventions of merit. In these cases, the existing rules are already fashioned to reward merit in a justified way, so that justice (in the sense of rewarding desert) consists simply in acknowledging that a given person satisfies the criteria of merit, and acknowledging that in accepting the convention, we accept the further implication that the person deserves what the rules say they deserve. Continue reading

Desert and Merit (3)

The value or worth of a man is, as of all other things, his price; that is to say, so much as would be given for the use of his power, and therefore is not absolute, but a thing dependent on the need and judgement of another.

–Hobbes, Leviathan, I.10.16

Sher’s account of desert and merit raises many questions, so let me double back to consider some of these, some addressed in his chapter, some not. I’d originally thought I’d leave the criticisms of Sher’s chapter at a single post, but it turns out that my criticisms have eaten up more space than I’ve thought they would. So this series on “Desert and Merit” is going to be longer than the promised or predicted two installments. Frankly, at this point, I couldn’t tell you how long it will be. As Michelangelo said (or is reported to me by Roderick Long to have said) about the Sistine Chapel, “It will be done when it is done.” I follow Michelangelo in such matters. Continue reading

Desert and Merit (2)

An unplanned installment in my series on “desert and merit,” care of Labcorp Drug Development. I applied to the job mentioned below three months ago, after spending eight months cleaning hospital operating rooms. I leave it to the reader to decide what conclusion to reach about my just deserts, based on my merits (or not) as a cleaner.

Dear Irfan,

Thank you for applying to Labcorp Drug Development as a Cleaner.

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Hit Me with Your Best Shot

Well, it looks like the pro-booster side has essentially won the argument, at least in the US, over whether boosters ought to be given for recipients of the Pfizer-Biontech COVID vaccine, six+ months after the second dose. My brother Suleman and I have (very incompletely) argued the case in favor of boosters here, here, and here. As front-line health care workers (he’s a physician, I worked in OR EVS), we got our first doses of the shot back in December 2020, and our second ones in January 2021. He works with COVID patients in a hospital, and I work in an increasingly crowded office. Neither of us had any sense of how much protection we were getting from the vaccine at this point.

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Bishop John Shelby Spong, RIP

I was saddened to learn today of the death of John Shelby Spong, Bishop Emeritus of the Newark, New Jersey diocese of the Episcopalian Church. Though I can’t claim to have known Bishop Spong very well, he was a close friend of my parents’, and a constant presence in our family home. He was for decades Chairman of the Board of Trustees of Christ Hospital in Jersey City, where both of my parents worked–my father for forty, and my mother for thirty years. So we knew Bishop Spong less as a bishop than as a hospital trustee. The stories–or legends–I heard about him for decades were about health care, not theology.

Spong speaking in England; photo credit: David Gibson/RNS

Christ Hospital started its life as an Episcopalian institution. It later merged (or attempted to merge) with St Francis Hospital across the city, a Catholic institution. The merger initiated an apocalyptic sectarian battle for the mortal souls of both hospitals, a battle in which (I’m told) Bishop Spong did a fair bit of the fighting. Eventually, after a series of Jesuit-worthy legal complications I’ve never been able to grasp, Christ Hospital was consumed by the godless and soulless CarePoint Health System. By then, Bishop Spong had had the good sense to leave the hospital behind; Jesus Christ may or may not have been resurrected, depending on your theology, but Christ Hospital was not going to be resurrected, at least not in the form it originally took as an urban community hospital in the Episcopalian tradition.

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New blogger: Suleman Khawaja

I wanted to welcome a new blogger to Policy of Truth, my brother, Suleman Khawaja. Suleman is currently a hospitalist at Valley Hospital in Ridgewood, New Jersey, where (in Ridgewood, not at Valley) he also runs a private practice as an expert witness on a variety of medico-legal issues. He received his BA in Political Science (minoring in Philosophy) at Duke University, and got his MD at the Pritzker School of Medicine at the University of Chicago. He did his residency in Internal Medicine at UNC Medical Center in Chapel Hill, North Carolina. By a strange coincidence, both Suleman and I studied extensively with Alasdair MacIntyre–as a graduate student at Notre Dame in my case, and as an undergraduate at Duke in his.

Suleman will be blogging here primarily on health care issues, with a particular focus on the COVID-19 pandemic.